2022-2023 Registration Form GSA - Gratiot County Strings

2022-2023 Registration Form

Student's Name

Address

School

Grade

Student Cell Phone

Student Email

Instrument

ViolinViolaCello

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Parent/Guardian (1)(if student is under 18)

Address(if different from student)

Best Phone #

Best Email

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Parent/Guardian (2)(if student is under 18)

Address(if different from student)

Best Phone #

Best Email

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In case of an EMERGENCY during class or rehearsal, who would be the best person to call?Please specify name and phone number.

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In situations of time-sensitive announcements, such as a last-minute cancellation, what is the best way to reach you quickly?

EmailText

Please specify the email or phone number to best contact you:

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It is extremely important that your child is picked up immediately after their session is complete. In the event that a parent/guardian above cannot pick up the student, list another adult who is authorized to pick them up.

Name:

Phone Number:

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Please explain any medical concerns below (allergies, medications, other special needs, etc.):

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I give permission for my child to participate in the Gratiot String Assocation program. I give permission to the staff to obtain medical care for my child in case of an emergency and to use my child's pictures for program promotion, including for organizations from which GSA receives grants. I have arranged for my child to attend class on a regular basis and will encourage my child to practice regularly. I agree to pay the tuition selected above, and I will support GSA activities.

Signature Of Parent / Guardian:

Date:

All classes meet in the west basement of First Presbyterian of Alma, 495 Charles Ave; use outside stairwell at west end of building.

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Tuition Payment Options

Family discounts apply for members of the same immediate family.
Scholarships may be available based on need. Please use the scholarship application form on our website. In addition, please visit the Ross Maki Memorial Fund at www:charitysmith.org for another financial resource.

Tuition is based on class times, which increase as students advance. Multiple members within the same immediate family are eligible for discounts.

Class/Ensemble	Full Tuition	Tuition (1/2) for 2^nd family member	Tuition (1/4) for 3^rd family member
Sinfonia I-IV	405	205	105
Horizons	420	220	120
Philharmonia, SSE	450	250	150

Please choose a payment plan:

Full payment by check or cash enclosed (a $10 fee will be charged for returned checks.) Full payment by credit card, paid thru ABC Music (call Jan Caputo 989-400-6361 to do this)Three payments: Three checks enclosed each for 1/3 of total tuition (dated October 1, 2022; December 1, 2022; and March 1, 2023). Checks will be deposited as dated.

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Payment, proof of payment (ABC music credit card receipt), or post-dated checks are required. Please deliver your payment to any teacher at any class, -OR- mail to Gratiot String Association, P.O. Box #491, Alma, MI 48801.

Full refunds will be provided if written notification that the student will no longer participate in the program is given by November 15, 2022. If tuition was paid in full, half of the tuition may be refunded if written notification is given after November 15, 2022 but prior to January 15, 2023 that the student will no longer participate in the program. No refunds are issued for drop outs after February 15, 2023

For any additional information, call or email either of the GSA teachers:

Faith Chaffee 231-330-2254 or frc71@sbcglobal.net

Jan Caputo 989-400-6361 or janettecaputo@gmail.com